DDx 2 Ear Pain & Hearing Loss (Quiz 1)

if a patient is 0-2 years old and experiencing ear pain, what is the likely diagnosis?

otitis media

what are the symptoms of acute otitis media?

sudden piercing ear pain, trouble hearing, fever up to 104, tugging or pulling at the ears, fluid drainage from the ears, loss of balance, nausea, vomiting, diarrhea, congestion

if a patient has had trauma to the ear and there is fluid leaking from the ear what is the likely diagnosis?

a fracture

if a patient has had trauma to the ear and is experiencing dizziness/tinnitus, what is the likely diagnosis?

perforated ear drum or perilymphatic fistula

if a patient has a present or past upper respiratory infection and they are experiencing dizziness and/or hearing loss, what is the likely diagnosis?

labyrinthitis

if a patient has a present or past upper respiratory infection and they are experiencing ear fullness or blockage, what is the likely diagnosis?

actue otitis

if a patient has ear pain that is associated with chewing/jaw motion and it is worse when eating hot/cold/sweet food, what is the likely diagnosis?

cavity, pulpitis etc

if a patient has ear pain that is associated with chewing/jaw motion and it is worse when biting down, what is the likely diagnosis?

TMJ syndrome or cracked tooth

if a patient has ear pain that is associated with chewing/jaw motion and it is worse when opening jaw with or without clicking and refers to the front of the ear, what is the likely diagnosis?

elongated styloid process

if a patient has ear pain that is associated with chewing/jaw motion and it is worse when opening jaw and has clicking what is the likely diagnosis?

TMJ syndrome

if a patient is complaining of ear pain and have recently been traveling by air or scuba diving, what is the likely diagnosis?

barotrauma or eustachian tube dysfunction

if a patient is flying and has ear pain mostly upon the descent what is the likely diagnosis?

eustachian tube problem

if a patient is having ear pain and says that the pain came on after swimming, what is the likely diagnosis?

otitis externa, rupture of tympanic membrane

if a patient has ear pain and has recurrent ear infections, what is the likely diagnosis?

rupture of tympanic membrane

if a patient is experiencing sudden hearing loss, what are some possible causes?

trauma, vascular disorder or viral infection

if a patient is having sudden hearing loss following an injury to the head, what is the likely diagnosis?

temporal fracture

if a patient is experiencing sudden hearing loss and has a history of TIA or coronary disease, what is the likely diagnosis?

vascular infarct affecting cochlear nerve

if a patient is having sudden hearing loss that resolves within 10 days, what is the likely diagnosis?

viral infection

if a patient has recurrent hearing loss, what are the likely causes?

ménière’s disease, chronic OM, impacted cerumen, eustachian tube problem

if a patient has recurrent hearing loss with associated dizziness, what is the likely diagnosis?

ménière’s disease

if a patient has recurrent hearing loss with associated allergies, what is the likely diagnosis?

auditory tube dysfunction

what is the presentation of otosclerosis?

20-30 y.o patient complaining of difficulty hearing through the telephone

what is the etiology of otosclerosis?

unknown, familial tendency

what is otosclerosis?

progressive sclerosis of the bony capsule and ear ossicles

if the cochlea becomes compressed with otosclerosis, what happens?

permanent hearing loss

what does examinantion of otosclerosis reveal?

rhine test reveals louder and longer bon conduction, weber test localizes to involved ear if unilateral

what is the treatment for otosclerosis?

microsurgery (staoedectomy) in case of severe hearing loss

what is the presentation of presbycusis?

elderly patient complaining of hearing difficulty/increased tinnitus that is worse in noisy enviroments, crowded rooms etc

what is the etiology of presbycusis?

damage to hair cells of the organ of corti resulting in selective high tone frequency hearing loss; variable relationship to nois trauma

if a patient with presbycusis has cerumen buildup or effusion, what type of hearing loss do they have?

conductive

what is the management of presbycusis?

numerous types of hearing aids available

what is the presentation of acoustic neuroma?

50-60 y.o with mild but constant hearing loss/dizziness sometimes with tinnitus

what is the etiology of acoustic neuroma?

benign schwannoma of vestibular nerve located in cerebellopontine angle

what are the exam findings of acoustic neuroma?

no clinical findings until it gets very large, auditory tests reveal poor speech discrimination, hearing loss is sensorineural

what is the treatment for an acoustic neruoma?

observation, radiation, or microscopic surgery